Provider Demographics
NPI:1215101654
Name:K & G AMBULANCE LLC.
Entity type:Organization
Organization Name:K & G AMBULANCE LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:KNOWLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-585-7876
Mailing Address - Street 1:594 SAWDUST ROAD
Mailing Address - Street 2:@233
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2215
Mailing Address - Country:US
Mailing Address - Phone:832-585-7876
Mailing Address - Fax:832-381-3331
Practice Address - Street 1:25275 BUDDE RD STE 34
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-2362
Practice Address - Country:US
Practice Address - Phone:832-585-7876
Practice Address - Fax:713-669-1091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000126341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX194599001Medicaid
TXAMB723Medicare PIN